Symptoms:

• Cough
• Decreased alertness or concentration
• Decreased urine production
• Difficulty sleeping
• Fatigue, weakness, faintness
• Irregular or rapid pulse
• Loss of appetite, indigestion
• Nausea and vomiting
• Neck veins that stick out
• Need to urinate at night
• Sensation of feeling the heart beat (palpitations)
• Shortness of breath with activity, or after lying down for a while
• Swelling of the abdomen
• Swelling of feet and ankles
• Weight gain

Infants may sweat during feeding (or other activity).

Some patients with heart failure have no symptoms. In these people, the symptoms may develop only with these conditions:

• Abnormal heart rhythm (arrhythmias)
• Anemia
• Hyperthyroidism
• Infections with high fever
• Kidney disease

Signs and tests:

A physical examination may reveal the following:

• Fluid around the lungs (pleural effusion)
• Irregular heartbeat
• Leg swelling (edema)
• Neck veins that stick out (are distended)
• Swelling of the liver

Listening to the chest with a stethoscope may reveal lung crackles or abnormal heart sounds. Blood pressure may be normal, high, or low.

The following tests may reveal heart swelling or decreased heart function:

• Cardiac MRI
• Chest CT scan
• Chest x-ray
• ECG, which may also show arrhythmias
• Echocardiogram
• Heart catheterization
• Nuclear heart scans

This disease may also alter the following test results:

• Blood chemistry
• BUN
• Complete blood count
• Creatinine
• Creatinine clearance
• Liver function tests
• Serum uric acid
• Serum sodium
• Urinalysis
• Urinary sodium